[Rupture of the diaphragm caused by closed trauma. Case contributions and review of the literature].
OBJECTIVE
Retrospective evaluation of 19 diaphragmatic ruptures due to blunt trauma.


METHODS
We collected all patients with thoracic and/or abdominal blunt trauma who were admitted to the department of surgery (Clinica Chirurgica and Chirurgia generale C) from 1970 to 1995. We selected patients with ascertained diaphragmatic rupture.


RESULTS
We considered 17 cases of TDR (15 males and 4 females). Mean age was 38 years (range 16-67). Radiologic findings were consistent with TDR in 10 cases out of 17 (58.8%). Right hemidiaphragm was injured in 6 cases (31.6%). 10 patients (52.6%) presented at operation with intrathoracic visceral herniation. 8 patients underwent laparotomy, 7 both laparotomy and thoracotomy, 4 thoracotomy alone. Perioperative mortality was 15.7% (3 patients).


CONCLUSIONS
The clinical features were complicated by a large number of associated lesions; radiologic diagnosis is comparatively easy if visceral herniation into the thorax is present, repeated radiologic examinations facilitate diagnosis. The surgical access is determined by concomitant associated injuries which may require urgent operation.
Montresor
E
E
Dipartimento di Chirurgia, Cattedra di Chirurgia Generale, Università degli Studi di Verona.
Mangiante
G
G
Vassia
S
S
Barbosa
A
A
Attino
M
M
Bortolasi
L
L
Nifosi
F
F
Modena
S
S
Puchetti
V
V
D000293:Adolescent; D000328:Adult; D000368:Aged; D003964:Diaphragm / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000150:complications; D011859:Radiography; D012189:Retrospective Studies; D012421:Rupture / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D014949:Wounds, Nonpenetrating / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery
La rottura del diaframma da trauma chiuso. Contributo casistico e revisione della letteratura.